![]() ![]() ECG characteristics of the tachycardia may be misleading as they are more often atypical in patients after ASD repair.Īblation Atrial flutter Atrial septal defect repair.Ĭopyright © 2013 Elsevier Ireland Ltd. The mechanism of atrial flutter did not differ in relation to the mode of ASD closure (direct suture versus patch closure). Isthmus dependent right atrial flutter is the leading AT mechanism in patients with a history of ASD repair. Five patients (11%) developed atrial fibrillation. During a mean follow-up of 7.7 ± 3.7 years, 27 patients (60%) remained free of any arrhythmia, two patients had AT recurrence with different mechanisms compared to the first procedure and underwent successful ablation. Follow-up was complete in 45 of 54 patients. Of note, 83.3% of clockwise typical flutter ECGs had long isoelectric lines (mean 74.5 ms). However, all clockwise typical atrial flutter patients showed the characteristic positive P-waves in the inferior leads. Only 70.6% of patients with proven isthmus dependent counter-clockwise atrial flutter presented with an ECG morphology typical for this mechanism. The mechanism of AT (typical atrial flutter (n=29), atriotomy-dependent flutter (n=7), and double loop flutter (n=5)) did not differ with regard to type of surgery. The leading mechanism was isthmus-dependent right atrial flutter in 29 patients (69.0%) with clockwise atrial activation in 41%. All patients had right atrial macro-reentrant AT. This type of AFl is associated with predominantly negative F waves in the inferior ECG leads. In 42 patients (77.8%), electrophysiological studies were performed in AT. Common right AFl is type 1 AFl exhibiting either a counterclockwise or a clockwise RA rotation and a proximal to distal CS depolarization. In 30 patients (55.6%) ASD had been closed by direct suture, 24 patients (44.4%) had a patch for ASD repair without significant difference in terms of gender and age at the time of the procedure (p=0.234, p=0.231). We investigated ECG characteristics and the electrophysiologic mechanism of AT in this collective and analyzed follow-up data.ĭata of 54 patients (47.3 ± 14.5 years, 35 females) were included. The purpose of this study was to evaluate clinical and electrophysiologic characteristics of AT in patients after surgical ASD repair as well as outcome after ablation.Ītrial tachycardias (AT) are a common complication after surgical closure of an atrial septal defect (ASD).įrom a prospective ablation database we analyzed data of patients with a history of ASD repair who presented to our institution for AT ablation. ![]()
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